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. 2025 Feb;26(2):246-257.
doi: 10.1007/s11121-025-01782-2. Epub 2025 Feb 4.

Indigenous Community-Level Protective Factors in the Prevention of Suicide: Enlarging a Definition of Cultural Continuity in Rural Alaska Native Communities

James Allen  1   2 , Lisa Wexler  3 , Charlene Aqpik Apok  4 , Jessica Black  5 , James Ay'aqulluk Chaliak  5 , Katie Cueva  5 , Carol Hollingsworth  5 , Diane McEachern  6 , Evon Taa'ąįį Peter  5 , Jessica Saniguq Ullrich  7 , Andrew Grogan-Kaylor  3 , KyungSook Lee  5 , Carlotta Ching Ting Fok  5 , Matthew Berman  8 , Suzanne Rataj  9 ; ANCHRR RSC; Stacy Rasmus  5
Collaborators, Affiliations

Indigenous Community-Level Protective Factors in the Prevention of Suicide: Enlarging a Definition of Cultural Continuity in Rural Alaska Native Communities

James Allen et al. Prev Sci. 2025 Feb.

Abstract

Suicide research has focused primarily on risk factors at the individual level, overlooking the potential for community-level factors that confer protection from suicide. This study builds on the concept of cultural continuity from the Indigenous suicide prevention literature. It seeks to understand the collective influences shaping individual experiences across time and frames resilience as a culturally situated process that helps individuals to navigate challenges and facilitate positive health behaviors. A collaborative Alaska Native (AN) partnership designed the Protective Community Scale (PCS) to identify mutable community-level protective factors in rural AN communities hypothesized to reduce suicide among youth, who represent the highest risk demographic in this at-risk population. Study objectives were to (a) test the measurement structure of community-level protection from suicide, (b) select best functioning items to define this structure, and (c) test the association of community protection with community-level suicide deaths and attempts. In 65 rural AN communities, 3-5 residents (n = 251) were peer-nominated for their knowledge of local resources and completed the PCS in structured interviews. Findings show community members can reliably assess the theoretically rich, multidimensional community-level protective factor structure of cultural continuity with sufficient precision to establish its inverse association with community-level suicide. Community-level protection emerges as a promising approach for universal suicide prevention in Indigenous contexts that can guide multi-level strategies that expand beyond individual-level, tertiary prevention to focus on the continuity of cultural processes as resources to build protection. These findings point the field toward consideration of cultural continuity and community protection as key factors for Indigenous suicide prevention.

Keywords: American Indian/Alaska Native; Bayesian multilevel structural equation modeling; Community resilience; Community-level protective factors; Suicide prevention.

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Conflict of interest statement

Declarations. Ethics Approval: The article reports human subjects research approved by the Maniilaq Association Executive Board, Norton Sound Health Corporation Research Ethics and Review Board, and Yukon Kuskokwim Health Corporation Human Studies Committee as the three AN Health Corporation regions representing the 65 participating tribal communities and by the Alaska Area IRB and University of Alaska Fairbanks IRB. Following IRB and tribal health corporation board approvals, the project additionally notified each tribal council prior to data collection in their community and reported results back to each tribal council prior to this publication. Procedures used in this project adhere to the tenets of the Declaration of Helsinki. Consent to Participate: Informed consent was obtained from all participants in this research. Conflict of Interest: The authors declare no competing interests.

References

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    1. Allen, J., Levintova, M., & Mohatt, G. (2011). Suicide and alcohol-related disorders in the U.S. Arctic: Boosting research to address a primary determinant of health disparities. International Journal of Circumpolar Health, 70(5), 473–487. https://www.ncbi.nlm.nih.gov/pubmed/22067096 . - DOI - PubMed
    1. Allen, J., Wexler, L., & Rasmus, S. (2022). Protective factors as a unifying framework for strength-based intervention and culturally responsive American Indian and Alaska Native suicide prevention. Prevention Science, 23(1), 59–72. https://doi.org/10.1007/s11121-021-01265-0 - DOI - PubMed
    1. Allen, J., Charles, B., Fok, C. C. T., Lee, K., Grogan-Kaylor, A., Qungasvik Team, & Rasmus, S. (2023). Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention. American Journal of Community Psychology, 71(1–2), 184–197. https://doi.org/10.1002/ajcp.12621 - DOI - PubMed

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